The purpose of this proposed 3-year project is to evaluate the effectiveness of various approaches to the education of adults with asthma and to identify those types of patients for whom various approaches might be more or less cost effective. The critical self-management practices for adults with asthma will be identified by using new data collected via the critical incident technique to supplement an existing set of prevention, intervention, and coping skills identified in children. An individualized and a group administered educational program will then be developed, based on the identified critical skills and using the same basic instructional models previously employed in AIR WISE and AIR POWER programs for children with asthma. Three hundred subjects with moderate to severe asthma will be recruited from participating clinics in the Northern California Kaiser-Permanente Medical Group for a randomized clinical trial of these programs. Subjects will be assigned to one of the two educational programs or to an information/attention control or a data-only control group. Follow-up data on asthma knowledge, attitudes, self-management practices, asthma symptoms, morbidity and health care utilization will be collected on all subjects for 15 months. Baseline data on the entire population of 300 patients will be used to refine a path model of self-management practices for asthma. Program effectiveness will be evaluated in terms of pre-post changes in the patients' knowledge, attitudes, self-management practices, medical condition, daily functioning, and utilization of services. Cost effectiveness will be evaluated using cost-of-care and cost-of-program implementation data provided by K-PMG. Specific attention will be paid to patient/program interactions and the types of patients for which the different educational approaches (including the minimal approach offered in the information/attention control condition) are most cost effective.